Health

Immunization status and birth order

Article Abstract:

Secondborn children appear to be immunized later in life than their firstborn siblings. Researchers reviewed the medical records of 446 sibling pairs to study immunization patterns. Significantly more firstborn children than secondborn children were fully immunized at all ages between five and 12 months of life. Firstborns were significantly more likely than secondborns to receive the second and third doses of the diphtheria and tetanus toxoids and pertussis vaccines DTP2 and DTP3 on time. In families where either child was vaccinated late, immunizations of secondborns tended to be particularly delayed. If the firstborn received DTP1 late, the secondborn was more than three times as likely to receive DTP1 late compared to other secondborns.

Hand-carried immunization cards may provide immunization histories as accurate as those in medical records. Researchers compared the immunization information in hand-carried immunization cards to that found in medical records for 257 children four months to six years of age. In 85% of cases, the immunization histories in the cards and medical records matched exactly. Immunization cards may be more readily accessible than medical records, especially if patients are in the habit of bringing cards to each medical appointment. Immunization cards can be especially useful for patients who change doctors often or who visit clinics.

Programs to use emergency department (ED) facilities to screen and vaccinate children who are patients do not seem cost-effective. The programs may provide a temporary rise in the immunization rate but the amount of time expended by personnel is excessive in proportion to the gains. In a study in two emergency rooms in the New York City area, patients were screened and offered vaccination. A follow up six-months later showed that the numbers of those vaccinated in the ED and those not vaccinated there were about equal in terms of immunization being up to date.